摘要
目的系统评价3D-TOF-MRA诊断颅内动脉瘤(IAN)的临床价值。方法计算机检索CNKI、EBM、VIP、Wanfang data中文数据库以及Cochrane Library、Pub Med、Embase、Web of Science外文数据库中3D-TOF-MRA诊断IAN的文献,检索时间截止至2016年9月。由两位评价员按照预先设定的纳入与排除标准独立筛选文献、提取资料,利用QUADAS-2工具评价纳入研究的偏倚风险后,采用Stata 12.0软件进行Meta分析,计算合并敏感性(Sen)、特异性(Spe)、阳性似然比(+LR)、阴性似然比(-LR)、诊断比值比(DOR),绘制受试者工作特征(SROC)曲线并计算曲线下面积(AUC)。结果最终纳入27篇文献的34个研究,共计4886例患者和2003枚可疑IAN。Meta分析结果显示,3D-TOF-MRA诊断颅内动脉瘤的Sen_(合并)=0.95[95%CI(0.93,0.97)]、Spe_(合并)=0.95[95%CI(0.92,0.97)]、+LR_(合并)=19.39[95%CI(11.51,32.67)]、-LR_(合并)=0.05[95%CI(0.03,0.08)]、DOR_(合并)=375.85[95%CI(174.87,807.83)]、AUC=0.99[95%CI(0.97,0.99)]。亚组分析结果:3D-TOF-MRA在3.0T高场强诊断IAN的敏感性高于1.5 T低场强(P<0.05),研究标准和有无蛛网膜下腔出血对3D-TOF-MRA诊断IAN影响不显著(P>0.05)。结论 3D-TOF-MRA对诊断颅内动脉瘤具有明确的诊断价值,高场强能提高3D-TOF-MRA诊断IAN的价值。
Objective To evaluate clinical value of 3-Dimensional time of flight magnetic resonance angiography （3D-TOF MRA） in the diagnosis of intracranial aneurysm（IAN）.Methods Articles about diagnosis of IAN by 3D-TOF MRA until September 2016 were searched in the databases such as Cochrane Library,PubMed,Embase,Web of Science,CBM,VIP,Wanfang data and CNKI.Two reviewers independently screened literature and extracted data according to preset inclusion and exclusion criteria and assessed risk of bias by QUADAS-2 tool.Meta analysis was performed by Stata 12.0 software.The pooled weighted sensitivity,specificity,＋ LR,-LR and DOR were calculated;SROC was drawn.Results A total of 27 articles and 34 studies were included,involving 4886 patients and 2003 suspicious IANs.Results of the meta analysis showed that the pooled sensitivity,specificity,＋ LR,-LR,DOR and AUC of 3D-TOF MRA for diagnosing IAN were 0.95 （0.92,0.97）,0.95 （0.92,0.97）,19.39 （11.51,32.67）,0.05 （0.03,0.08）,375.85 （174.87,807.83） and 0.99 （0.97,0.99）,respectively.Results of the subgroup showed 3D-TOF MRA had better sensitivity in 3.0T compared with 1.5 T（P 〈 0.05）,study standard and with or without SAH have no significant differences in IAN diagnosis （P 〉 0.05）.Conclusion 3D-TOF MRA has definite efficiency for assessing IAN,especially in high field studies.
出处
《临床放射学杂志》
CSCD
北大核心
2017年第10期1396-1400,共5页
Journal of Clinical Radiology
